IS TOO PERFECT... IMPERFECT?

Finding roommates your freshman year is often the equivalent of inserting some coins into a Morongo Casino and Resort slot machine, yanking down the lever, and crossing your fingers that three of those lucky number sevens will walk through your apartment door on move-in day.

Amber Carrington knew the feeling.

She was excited to start her college career at the University of California, San Diego and was looking forward to meeting the people she would spend the next school year sharing asking: "who ate my leftovers in the fridge?"

Apparently, Amber had some beginner's luck with that "suite-mate" slot machine because in pranced two beautiful girls, introducing themselves as her new roommates.

She liked them. They got along. However, Amber soon learned that there was a deeper issue buried beneath their perfectly-manicured, aesthetically-pleasing exteriors... and it was something that's become more common over recent years.

Amber's new roommates were obsessed with social media.

According to the Pew Research Center, 90% of young adults, aged 18-29, are on social media, so it's no surprise that many are "obsessed" with the digital platforms.

However, for Amber's roommates, the Instagram infatuation went beyond the several hours a day spent "liking" strangers' filtered photos.

"They developed these eating disorders, and they just got really bad. I think social media induced a lot of that," Amber said. "I would have to take their phones away from them because they would just look up pictures, not only of influencers, but of themselves on their Instagram five years ago, three years ago, when they thought they were skinnier or prettier. That was really hard, and it's an issue that I've seen in every part of my life, even in high school and in college."

What Amber describes is no longer uncommon among young adults who use the visual social media apps on a daily basis.

Social Media Sparking Social Isolation?

Jean Twenge, a professor of psychology at San Diego State University, analyzed studies done by the National Survey on Drug Use and Health. She found that young adults reporting symptoms consistent with major depression increased 63% from 2009 to 2017. Young adults with suicidal thoughts also increased 47% from 2008 to 2017.

Coincidentally, this was the same time period in which social media originated and gained popularity.

Isaiah Pickens, Ph.D., Clinical Psychologist

Clinical psychologist Isaiah Pickens, Ph.D., works with teenagers and said he's noticed increased levels of anxiety and depression in his clients.

He said that this younger generation, more than any other, "has greater levels of anxiety and depression, partially tied to feelings of social isolation that in many ways, ironically, can potentially be tied to social media and technology use."

According to an American Journal of Preventive Medicine study, individuals who visited social media at least 58 times per week were three times more likely to feel socially isolated compared to those who logged into the platforms less than nine times per week.

"It can magnify some of these insecurities or challenges that have traditionally been a part of growing up, being a teenager," Pickens said. "Now, being compared or feeling compared to not just your immediate community, but the worldwide community through social media can potentially magnify the process by which people feel some of these mental health challenges."

JT Arowosaye, E! News Digital Video Team

Photo Credit: @JT.Arowosaye Instagram

Twenty-four-year-old JT Arowosaye works with social media professionally as part of E! News' Digital Video team. She agrees that the comparison aspect of social media can have harmful effects on users' mental health.

"It's like a constant mirror of yourself every day, but it's not even an accurate mirror," said JT. "Then on top of that, it's also trying to explain to you where you should be and what you should be doing in life, and that's not always accurate either."

She said that her social media use started off innocently but then turned into a "beast"... so much so that JT decided to create an entirely separate Instagram account to avoid FOMO ("fear of missing out") by seeing what other people were doing.

University of Southern California graduate student Natalie Reddington has a similar experience with social media, feeling as though the digital platforms consume her life and make her often compare herself to the lavish lifestyles posted on her feed.

Natalie Redington, USC Graduate Student

Credit: @nred9 Instagram

"I feel like social media for me is generally just bad for my overall wellbeing and mental health," Reddington said. "There was a point last year, I would just delete social media, the apps on my phone, throughout the week because it was just too much of a distraction. It's almost an obsessive thing where you're like, 'okay, I want to check Instagram. I want to know what's happening.' But it's like, why do I even care? I was just on this app, why am I back on it? To see the same stories we've seen people posting?"

One such phenomenon that has derived from young adult's social media use is the concept of "Facebook depression." The American Academy of Pediatrics defines this as "depression that develops when preteens and teens spend a great deal of time on social media sites, such as Facebook, and then begin to exhibit classic symptoms of depression."

The AAP claims that the intensity of the online world can lead to young people developing mental health issues as they try to maneuver the currency of likes and followers.

"I think [likes and followers] matter, but it matters in the context of how it's shaping a person's identity in the sense of who they are," Pickens said. "There's another theory that I think really helps us understand how teens might kind of operate in different situations, and it's called 'identity-based motivation theory.'"

The theory was developed by University of Southern California psychology professor Daphna Oyserman, and it deals with how one's identity shows up in different situations. It can lead people to reach for certain goals or avoid certain goals depending on what is motivating them.

"I would kind of connect that idea of identity with how people are processing their likes and follows," Pickens continued. "It's a huge part of their identity in terms of how they're seeing themselves. I think it can lead to more volatility. The 'likes' and all these things matter, but they don't have the same kind of weighted impact on them as it might other kids who don't have other forms of support."

Amber Carrington Advertising Uggs on Instagram

Credit: @ambcarrington Instagram

Amber, now a senior at the University of Southern California, has become a social media representative for various brands, including Sony Music, Uggs, and Gorjana Jewelry. She's paid to advertise these companies' products on her social media, which means having a certain number of followers.

Twenty-three-year-old former collegiate cheerleader Carrie Marquart is also a brand representative for a hair care company and admits to often looking at her number of followers, the amount of likes her posts get, and the number of people engaging with her account.

Carrie noticed an emphasis on social media engagement when recruiting for her sorority at the University of Washington in Seattle, saying they had "a UW fall recruitment hashtag, and it was a really big obsession [which sorority] would have the top posts because it kind of just tells you how well you're doing in recruitment."

She said her sorority asked members to submit influencer-esque lifestyle pictures for the sorority's Instagram account as a way to promote itself.

Carrie also felt pressure as a cheerleader to constantly keep up a very polished image on social media, refusing to ever post pictures in which she looked "questionable."

This evidences the very large role that the visual element of social media plays on mental health.

Carrie Marquart (Left), Former University of Washington Student and Cheerleader

Credit: @vanilllllathunder Instagram

The filtered, digitally retouched, and cosmetically tweaked faces of social media influencers develop a standard of beauty that cause some users to feel a pressure to obtain.

"I think the visual component is an important piece to consider," Pickens said. "Social media and these visual mediums have potentially created environments where people feel potentially more anxious, more depressed because of what they're seeing. The visual component kind of promotes or heightens the sense that this person does not fit in, this person does not belong."

While studying abroad in Australia, Amber noticed how prominent "influencer culture" is there and how all of the digital personalities looked alike.

"They're all the exact same. They're all really tan, and they're really fit, and they are all the same ambassadors for the same clothing lines," Amber said. "They're gorgeous and I would love to look like them in one life, but I don't think I'm ever going to look like that."

"I mean, I wish I looked better in some photos or obviously wish I looked like a model, but it's not reality," she continued. "If you keep living in those apps, then you're going to skew your perception of yourself so much where you're ultimately just going to start hating what you look like."

Pickens said the filtered representations that influencers post on social media has absolutely skewed users' perceptions of themselves.

"I think sometimes these social influencers can further promote these feelings of anxiety around one's body," he said. "When they have body dysmorphic disorder, one of the key features is a cognitive process of perfectionism, constantly thinking or needing your body to look perfect, even though that idea of perfect is unrealistic and not attainable. I think in some ways these social influencers can really reinforce some of those beliefs around your body not being good enough."

new (digital) nose, who dis?

This has led many social media users to download such applications as FaceTune to digitally retouch their facial and bodily features on photos. Whether it be digitally smoothing their skin, slimming their waist, shrinking their nose, or whitening their teeth, more than a million subscribers use FaceTune to "improve" or radically change their outer appearance before posting a photo.

"It definitely impacts self-esteem, even if you know better," JT said. "I've worked in this industry, so the people I'm seeing on Instagram that are influencers or famous, I see them in real life and I'm like, 'wow, you don't look like that; or yeah, you really do have bad skin, and you definitely FaceTuned everything.' But I still succumb to those feelings and those sentiments."

"Where it affects my self-esteem is with dating and looks because I know those girls Photoshop their bodies or they got plastic surgery or whatever," JT continued. "I still feel pressure to look a certain way or attempt to look that way even though I know these girls also don't actually look that way."

Amber said that she's had a friend who digitally retouched her face in dating app photos, which led to a surprise when she would actually meet her matches.

"Because she used FaceTune, she looked like a different person," Amber explained. "It's really scary, and I guess if [the apps] help people like themselves better in the moment, it's okay, but in the long-term aspect, they're really, really bad for our mental health."

So how can apps like FaceTune impact people long-term?

Cosmetic Craze

Some social media users ultimately decide to make permanent changes to their looks to match the visually appealing aesthetic seen on their daily feeds.

Demetri Arnaoutakis, M.D., Plastic Surgeon

Dr. Demetri Arnaoutakis is a board-certified facial plastic surgeon in Beverly Hills who deals with people often coming in with pictures of social media influencers or popular internet celebrities and models like the Kardashians and Hadids, asking to look more like them.

"I think now with the rise of social media, this stuff is in our faces 24/7. You could log on to Facebook, Instagram, Twitter, you name it, and your favorite celebrity, your favorite influencer, your favorite actress, are open about their treatments," Dr. Arnaoutakis said. "They're promoting what they're getting done, and so you're an impressionable teenager or college student or whatever it may be, a fan, you see what they're having done, and you want to get it done yourself."

Dr. Arnaoutakis has noticed a significant rise in young people coming in to get cosmetic consultations over the past five or 10 years as it relates to the growing popularity of influencers.

Certain procedures or injections have become popular based on the trends of social media celebrities.

For example, some clinics reported a 70% increase in lip filler inquiries after Kylie Jenner admitted to getting them in 2015.

"I have offices in both Beverly Hills, California, and Tampa, Florida," said Dr. Arnaoutakis, "More commonly in my Los Angeles office, patients will come in with a photo [of an influencer]. Bella Hadid is probably the most common celebrity. People come in requesting her cat eyes and her high cheeks and her slender contoured lower face and her nose. It's a lot more common than you think."

While Dr. Arnaoutakis has noticed many of his clients coming in to consultations with pictures of influencers, fellow Beverly Hills plastic surgeon Dr. Leslie Stevens said that it can be a red flag when people ask to look like certain famous faces.

Leslie Stevens, M.D., Plastic Surgeon

"When someone comes in with a picture of a celebrity or movie star that they want to look like, it's kind of a red flag because that's really not a realistic expectation," Dr. Stevens said. "I mean it's one thing to use it to communicate what you want to do, but to actually say, 'I want to look like that,' I wouldn't touch those people. I try to talk to patients and make them understand what is possible, to keep them looking natural and not looking done because that's not my aesthetic."

Cosmetic surgery in general has also become a lot more common over the past few decades. According to the American Society of Plastic Surgeons, there has been a 163% increase in the number of annual procedures done a year between 2000 and 2018.

In fact, the American Society of Plastic Surgeons reported there were close to 1.7 million cosmetic, surgical, or minimally-invasive procedures performed on those aged 20-29 in 2018.

Dr. Stevens said people have now started younger with getting Botox, which includes getting injections of Jeuveaus or "newtox," which is essentially Botox marketed for younger people. He said that he has clients who've been getting Botox as a preventative measure since they were in their 20's. Dr. Stevens also said it's not uncommon to perform rhinoplasty, also known as a nose job, on girls who are 16 years old, but he recommends they wait to mature and finish puberty.

As for breast augmentations, Dr. Stevens also likes for his clients to completely mature and stop growing, but he said around 18 and older is appropriate for most.

Dr. Arnaoutakis believes social media is partly responsible for that increase in cosmetic surgery at younger ages.

"I think social media really, really influences the younger millennials and the younger population," he said. "They're constantly swiping and surfing the web and they see all these models and actresses, and they're always bewildered by how they look like that. I think they are definitely influenced, and they want to look like that on their pages as well."

Amber has noticed the cosmetic trends present amongst her friend groups, saying that "so many of the girls in [her] sorority have had their lips done or their boobs or their nose done."

"Some of the girls were talking about getting Botox," Amber said, "I was like, 'what the heck?' And they're like, 'Oh, preventative stuff. Like just to get rid of like a line on your face.'"

JT has also noticed the impact social media influencers on her friends getting cosmetic surgery.

"I think everyone who's getting something done, at least in my friend group, I'll definitely tell you influencers already have it," she said. "If they want their lips done, [it's because] an influencer has good lips or whatever. If it's boobs, you see a lot of influencers with their boobs pushed out, but like Kylie Jenner and obviously Kim Kardashian made that famous."

Cosmetic Procedures Promoting Confidence?

While JT is also been aware of people on social media achieving an unrealistic standard of beauty through cosmetic procedures, Natalie is interested herself in getting lip fillers. She's even saved up, had a consultation, and hopes to get them after graduation. She believes cosmetic surgery can help boost confidence and make people feel like their best self, which is something that Dr. Arnataoukis has noticed in his clientele.

"It's about improving people's lives," he said, "so we have someone who comes to us with something that they're not self-confident about, and we do our best to address that and fix it and let them be more confident, which translates not only from their personal life but to their work life too."

Social Media's Support System

While he pointed out the harmful effects social media has had on contributing to anxiety and depression in the younger generation, Pickens also made sure to clarify how it has positively impacted the lives of the teenagers he's met as well.

"People find communities that they otherwise would not have found when they're dealing with some of these challenges," he said. "To a degree, the avenue by which they are able to feel most comfortable or feel most disarmed are sometimes tele-health or discussion forums or other kind of visual mediums that potentially can provide support for things. They otherwise might have had difficulty connecting with someone within the past before these technologies existed."

He continued to say that "there is the positive of creating a support system when it's facilitated by someone who is in a healthy space and can pretty much create not only a safe space for people to feel like they can share, but also opportunities for people to connect with the type of higher level of support they need. That's something that is seen as a kind of a necessary component for the healing of a person."

As a part of our culture that doesn't seem to be going away anytime soon, Pickens shared his piece of advice for young adults and teens immersed in the visual world of social media.

Amber Carrington (First, L to R) With Friends

Credit: @ambcarrington Instagram

"I think one really important aspect is to practice lowering the stakes of their social media interactions, and what I mean by that is part of the anxiety comes from the fact that it feels like the stakes are so high," he said. "If I don't get that 'like' or 'follow,' then there's no one that likes me, and this kind of universal way of seeing every social media interaction can be very stress-invoking... Being able to affirm the fact that there are other important aspects in their life can be really, really important for teens and just developing some of these practices around self-awareness, gratitude can be powerful, and so just being able to develop some of those affirmations."

Amber advises young adults to stay off social media as much as possible and engage in real moments with real people.

Natalie agrees and encourages users not to compare themselves to the filtered photos influencers post on Instagram.

"Everybody is unique in their own way," Natalie said. "I am pretty in my own way. I am smart in my own way."